I cared for a 48-year-old Bosnian woman whose constant chest pain had worsened that day. Her evaluation in the Emergency Department did not reveal any evidence of heart disease. In broken English, with the help of her son translating, she admitted that stress could be causing her chest pain. Moreover, she quickly mentioned that her stress was justified. Ten years prior, two of her teenage sons were tragically killed in a car accident while driving to school. Stunned, I paused in condolence and consideration. Even though she failed me for not truly knowing the depth of her pain, I was not content to fail her in an opportunity to heal.
Aside from language, cultural and emotional divide, human beings rarely see eye-to-eye amid the limitations of the mind. With the additional concerns regarding her sciatica pain, I suggested she participate in stretching classes, in particular, the practice of yoga. She seemed receptive; I kept talking. Yoga denotes union and in this practice students yoke with the divine. Having experienced this transcendent feeling at the end of yoga classes and knowing a friend who cherishes this time to communicate with his deceased partner, I encouraged her to explore the practice of yoga and perhaps rekindle the bond with her sons. She was right about my not understanding her situation and it truly being outside the scope of my medical practice, but not out of my awareness.
The value of shutting off the mind and opening up the heart generally goes unrecognized. There are certain expectations placed upon physicians to heal everything; and many times we fail. Most patients enter the Emergency Department in anticipation of a prescription. I make certain they leave with a dose of awareness. Oftentimes, I might query if the patient learned a lesson. The art of medicine is the ability to have a heart-to-heart conversation even when tensions flare. The mere suggestion that her sons could not rest easy while their mother was still in pain gave my patient pause in her heartache and consideration. There was a nod and a smile in her demeanor that revealed a shift in her mindset. She may not have recognized me as an inner wounded child, but she knew I was speaking for her sons who longed for her to rest easy.
Despite making the effort to not fail patients, I rarely receive positive feedback from patients who take the time to write letters on my behalf. Through an uplifting stroke of thanksgiving on her discharge instructions, this woman sent my spirit soaring with a high mark for healing a great divide. The nurse who witnessed the entire conversation with this patient made certain I was aware of the grade I earned for having shared my yoga that day.